The invention concerns a method of after-care in relation to patients with at least one electromedical implant. In the case of patients, with at least one electromedical implant such as for example a cardiac pacemaker, a defibrillator, a cardioverter or another electronically actuated or controlled implant, it is necessary to implement more or less intensive after-care.
For that purpose, known methods generally involve a first telemetric data transmission between the implant and an associated external apparatus, with first data being transmitted from the implant to the external apparatus. On the occasion of an after-care examination of the patient in an after-care installation, at least the most up-to-date available data of the implant are then interrogated for giving the examining clinician information in the context of an after-care interrogation procedure, and sent for output to suitable output means.
After-care interrogation procedures usually implemented for example in the case cardiac pacemaker patients by means of short-range telemetry. That is generally complicated and expensive and tedious, as in that case, the external apparatus has to be applied directly to the skin of the patient and the external apparatus must remain positioned as accurately as possible over a relatively long period. On the other hand, it is known, for example, from U.S. Pat. No. 5,720,770 to implement remote diagnosis by way of suitable patient monitoring systems. That however, suffers from the disadvantage that the examining clinician does not have direct contact with the patient, but can at best question the patient by telephone, as is proposed in U.S. Pat. No. 5,720,770. Optical impressions and voice expressions from which an experienced doctor can draw important conclusions are lost in that case.
Therefore the object of the present invention is to provide a method of the kind set forth in the opening part of this specification, which permits fast, simple and reliable after-care examination in situ.
Based on a method as set forth herein, that object is attained by the features recited.
The invention includes the technical teaching of implementing in situ a fast, simple and reliable after-care examination. The data interrogation procedure, which is implemented in the context of the after-care interrogation operation, is effected prior to the after-care examination automatically after the patient enters an interrogation region of the after-care arrangement. Transmission of the data is effected by means of a long-range telemetry connection between the implant and the external apparatus. Alternatively or in addition, the transmission of data also can be effected at least in part by way of a mobile radio network or a fixed-line telecommunication network. In that respect, data transmission over a long range makes it possible for the patient to move more or less freely in the interrogation region. Automatic interrogation without the help of the examining clinician or any other personnel also relieves the load on the examining doctor or his staff.
Advantageously, to afford more extensive information for the examining clinician, besides the data interrogation procedure, at least one data set, which is stored in a central storage arrangement and which originates from a preceding implant data output, is automatically called up and sent for output to the output means so that the examining doctor can directly form a picture of the development of the patient.
For the purposes of particularly well-structured processing of the information, a central storage arrangement which is organized in the manner of a database is preferably used. Preferably, this involves a central storage arrangement with a coupled expert system, so that, for example, a comparison with cases in a similar situation is directly available to the examining doctor.
To provide more extensive information for the doctor, the telemetric data transmission can be used to generate tests, for example stimulus threshold investigation, stress tests for the response factor or shock tests, or also diagnosis programs, the results of which are transmitted by way of telemetric data transmission to the external apparatus.
To provide for a better and simpler evaluation of the information on the part of the doctor, the method preferably involves, prior to output by the output means, an automatic diagnostic pre-assessment operation and, alternatively or in addition, processing of the data.
In preferred variants of the method according to the invention, the external apparatus used is an external apparatus which is installed in the interrogation region, in which case data interrogation is preferably implemented as soon as the implant is in the interrogation range in relation to the external apparatus for a predetermined period of time.
In other variants, a mobile external apparatus which is carried around by the patient is used as the external apparatus. In that case, the external apparatus can be connected directly to a suitable interrogation device in the interrogation range and the interrogation procedure is thus automatically triggered.
It is likewise possible to use an external apparatus for remote monitoring, in which case data transmission is then effected by way of the remote monitoring system. In this case, triggering of the data interrogation procedure is then preferably effected by a first triggering device, which is installed in the interrogation range and which co-operates with an associated second triggering device of the implant and/or the mobile external apparatus.